Exosomal cargoes as potential biomarkers for latent tuberculosis infection: a promising frontier in diagnosis?

This article examines the potential of exosome analysis in diagnosing latent tuberculosis infection (LTBI). Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a significant public health challenge due to its high incidence worldwide. LTBI is a critical link in TB prevention and control but is also a major obstacle to achieving TB eradication. Current diagnostic methods, such as the tuberculin skin test and interferon-γ release assays, have limitations. Exosomes, small vesicles released by cells, contain DNA, RNA, proteins, and lipids that reflect the host cell's pathological state and may serve as novel biomarkers for LTBI diagnosis. The article introduces exosome formation and extraction methods, explores the pathological mechanisms of mycobacterial vesicles and exosomes from infected hosts, and reviews research progress on exosomal DNA, non-coding RNA, proteins, and lipids as diagnostic markers for LTBI. Despite their potential, exosome research and application face challenges, including complex separation and purification processes, the dynamic nature of LTBI, and biomarker specificity. Future research will require multidisciplinary collaboration to develop efficient exosome-separation techniques and to further investigate the clinical value of these biomarkers, ultimately promoting the application of exosomes in LTBI diagnosis and contributing to global TB prevention and control efforts.